Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 08356 | Date 15/06/2020 |
| Token No | SM/19-20/23121 15/06/2020 | Serial | 043 Last Visit: 15/06/2022 |
| Patient Name | Mrs. SAPNA BIBI | Contact No | |
| Address | 60/1 G.T ROAD SHEORAPHULI, BAIDYABATI (M) | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||